I could really use your expert opinion. I live in a shared space community where almost everyone loves gardening and landscaping. However, there is a woman with lupus who claims that mold in everything from soil to mulch gives her trouble. She's asked for some accommodations that reduce the amount of landscaping projects near her home - especially those that are in the path of the main wind patterns. She claims she cannot be on steroids because of her intolerance to synthetic pharmaceuticals and the long-term dangers and risks. Some people here really want to consider her health whereas others don't think that the gardening, etc. harms her as much as she claims. Could you answer a few questions?

Can a person with lupus/MCS get headaches, tissue pain, rashes, congestion, facial pain, swelling, insomnia, respiratory problems and bleeding in the lungs from the mold in exposed soil? Could these symptoms continue beyond the day of exposure? Can wind affect these reactions? Can straw, mulch, compost and composted manure cause these reactions? Isn't spring already so moldy that adding these sources wouldn't do much to her?

She claims to have so much pain and we're wondering if she's exaggerating. Can you clarify this mystery?

This is a tough case. A solid argument could potentially be made for both sides of the issue.

Allergens, such as molds and seasonal allergies, could potentially induce the immune system to make more antibodies and as such worsen the rheumatic diseases. I am not aware of any data showing this to be true; however, theoretically it is possible.

The flip side of the coin is that there is mold basically everywhere and attempts to reduce it are generally unsuccessul, so would gardening or landscaping worsen the issue? It is difficult to say that it would and just as difficult to say that it would not.

Here in Arizona, we have a fungus known as coccidiotis immitis (valley fever). The fungus lives in the soil and infection cases increase significantly following windy conditions or in places where the dirt is being disturbed (such as in construction areas).

Regarding the inability to take steroids, this is an issue I cannot comment on as I do not know this patients medical history. In general, intolerance of steroids is very rare but does exist.